Reid M J, Schwietz L A, Whisman B A, Moss R B
Allergy/Immunology Clinic, Wilford Hall USAF Medical Center, Lackland AFB, Texas 78236.
N Engl Reg Allergy Proc. 1988 May-Jun;9(3):225-32. doi: 10.2500/108854188779023450.
In 1984 Ramirez postulated the existance of two subgroups of patients with Mountain Cedar (MC) pollinosis. One subgroup had a single positive skin test (SPST) to MC only, lacked other atopic diseases, and required prolonged MC exposure to develop the disease. The second subgroup had multiple positive skin tests (MPST) in addition to MC, had other atopic diseases, and developed clinical symptoms after a shorter period of MC exposure. To validate these findings, and to explore the clinical and immunologic differences between these two subgroups, 13 SPST and nine MPST patients underwent immunotherapy with MC pollen extract. Six SPST and ten non-allergic controls did not receive immunotherapy. MC specific IgE (sIgE), MC sIgG, and MC sIgG subclasses were measured by ELISA pre and intra season. Symptom Medication Score (SMS) were measured during the MC season. SPST patients had a significantly lower baseline sIgE than MPST patients, 2.1 IU/ml versus 22.3 IU/ml, p = 0.023, and were also older than MPST patients, 52.4 versus 32.2 years, p less than 0.001. Baseline MC sIgG and MC sIgG subclass antibody levels were similar in both patient groups. SMS were lower in treated SPST patients compared to treated MPST patients, p less than 0.01, but in vitro responses to immunotherapy were not significantly different between the two groups. MC sIgE, MC sIgG, MC sIgG1 and MC sIgG4 rose in both treated groups. MC sIgG1 (but not MC sIgG4) rose during the MC season in both non-immunotherapy groups.(ABSTRACT TRUNCATED AT 250 WORDS)
1984年，拉米雷斯提出患有山雪松（MC）花粉症的患者存在两个亚组。一个亚组仅对MC有单一阳性皮肤试验（SPST），没有其他特应性疾病，且需要长时间接触MC才会发病。第二个亚组除了对MC有阳性皮肤试验外，还有多个阳性皮肤试验（MPST），有其他特应性疾病，且在接触MC较短时间后就出现临床症状。为了验证这些发现，并探索这两个亚组之间的临床和免疫学差异，13例SPST患者和9例MPST患者接受了MC花粉提取物免疫治疗。6例SPST患者和10例非过敏对照未接受免疫治疗。在季节前和季节中通过酶联免疫吸附测定法测量MC特异性IgE（sIgE）、MC sIgG和MC sIgG亚类。在MC季节期间测量症状药物评分（SMS）。SPST患者的基线sIgE显著低于MPST患者，分别为2.1 IU/ml和22.3 IU/ml，p = 0.023，且年龄也比MPST患者大，分别为52.4岁和32.2岁，p小于0.001。两个患者组的基线MC sIgG和MC sIgG亚类抗体水平相似。与接受治疗的MPST患者相比，接受治疗的SPST患者的SMS较低，p小于0.01，但两组之间免疫治疗的体外反应无显著差异。两个治疗组的MC sIgE、MC sIgG、MC sIgG1和MC sIgG4均升高。两个非免疫治疗组的MC sIgG1（但不是MC sIgG4）在MC季节期间升高。（摘要截于250字）
